Over-the-counter lipoic acid may slow the progression of multiple sclerosis, study finds

Lipoic acid reduced brain shrinkage in patients with secondary progressive MS
Compared to a placebo, it improved atrophy by 68% Portland researchers found
In comparison, FDA-approved drug ocrelizumab showed reduction of just 18%
People with SPMS don’t recover from relapses and see a worsening of disability
There’s no known cure for this or any type of MS, which affects 2.3m worldwide

Common over-the-counter antioxidant lipoic acid slows down the progression of multiple sclerosis, new research suggests.

The effects were seen on patients with the secondary progressive form (SPMS) of the common neurological disease.

In a pilot study, researchers found that taking a high dose of lipoic acid every day for two years reduced whole brain atrophy by 68 percent compared with a placebo.

Also known as thioctic acid, it is a naturally occurring compound that is synthesised in small amounts by humans, which is available in supplement form.

The findings offer new hope for patients with SPMS, for which there is currently no cure.

Lipoic acid may slow the progression of demyelinating disease multiple sclerosis (file)

TYPES OF MS

Relapsing-remising MS (RRMS) is the most common form of MS, in which people have distinct attacks of symptoms which then fade away either partially or completely.

Around 85 per cent of people with MS are diagnosed with this type.

It varies widely from person to person, but on average, around 65 percent of people with RRMS will develop secondary progressive MS (SPMS) 15 years after being diagnosed.

This means they have a sustained build-up of disability, completely independent of any relapses.

Primary progressive MS affects about 10 to 15 per cent of people diagnosed with MS. Symptoms gradually get worse over time, rather than appearing as sudden attacks (relapses).

There is currently no cure for any type of MS, but there are disease-modifying therapies available that may help to slow disease progression.

Multiple sclerosis (MS) is generally progressive and estimated to affect more than 2.3 million people across the globe.

It occurs when the immune system mistakes myelin – the fatty protective coating surrounding nerve cells in the central nervous system – for a foreign body and attacks it.

This damages and disrupts signalling between the brain and spinal cord, either partially or completely, causing vision and balance problems, dizziness, fatigue, bladder and stiffness and/or spasms.

How the research was carried out

Researchers from Oregon Health & Science University School of Medicine in Portland in the US carried out a randomized, double-blind study on 51 adults aged 40 to 70 years who all have SPMS.

A total of 27 participants were randomly assigned to receive 1,200 milligrams of lipoic acid every day for to years, while the remaining 24 were given a placebo.

Whole brain atrophy – which refers to the reduction in total brain volume due to the loss of neurons, considered a marker of MS progression – was assessed at the start of the study, a year in, and at the end using MRI scans.

HAVE SCIENTISTS UNCOVERED THE CAUSE OF MS?

Scientists may be one step closer to discovering a cure for the debilitating lifelong condition multiple sclerosis (MS).

Researchers have shown MS sufferers have high levels of a certain protein in their brain cells, which is virtually nonexistent in healthy people.

This protein alters the cells’ energy supply, triggering the disabling symptoms.

The finding may enable scientists to create protein-targeting treatments for the incurable disease.

Scientists at the Universities of Exeter and Alberta analysed human brain tissue samples.

They discovered high levels of a protein, known as Rab32, in MS patients.

Rab32 is thought to cause the part of the brain cell that stores calcium to get too close to the cell’s so-called energy supplier.

This causes miscommunication within the cell, leading to brain cell damage.

Although it is established that MS occurs due to nervous system damage, the cause of this was less clear.

Lipoic acid outperformed MS drug

The research, published in the journal Neuroimmunology & Neuroinflammation, noted that the reduction of brain atrophy by 68 percent with lipoic acid was greater than the reported impact of the drug ocrelizumab.

Known as brand name Ocrevus, the medication was recently approved by the Food and Drug Administration (FDA) for the treatment of primary progressive MS (PPMS) and the relapse-remitting (RRMS) form.

It was shown to improve whole brain atrophy by 18 percent in clinical trials when measured against another disease-modifying drug, interferon beta-1a.

Furthermore, the new study revealed participants treated with lipoic acid had fewer falls and better walking times, compared with those who were given the placebo.

The team found that lipoic acid was generally safe and well tolerated by participants, with the most common side effect being gastrointestinal upset.

However the drug manufacturer, Roche Products UK, says that the researchers’ comparisons are unfair.

Dr Marius Scholtz said: ‘The Phase III clinical trial for ocrelizumab, involved more than 700 patients with primary progressive MS, which is an entirely different patient population compared to the small pilot study of lipoic acid in SPMS involving only 51 patients.

‘As a result of the differences in patient population between these clinical trials, no meaningful comparisons can be made.’

Implications of the research

However, the researchers caution that further trials involving a larger number of patients is necessary before lipoic acid can be recommended as a safe and effective treatment for the disease.

‘These are high doses. And while it seems safe, we won’t know whether it actually improves the lives of people with MS until we can replicate the results in the pilot study through a much bigger clinical trial,’ said lead study author Dr Rebecca Spain.

The team plan to build on the results of their pilot study and carry out a further trial later this year.

‘Fortunately, we’re going to be able to answer that question with the participation of kind volunteers,’ added Dr Spain.

Dr Susan Kohlhaas, director of Research at the MS Society, said: ‘While it’s not possible to make comparisons between this potential treatment and others that have been tested in different trials, these early-stage results hold promise for people with progressive MS.

‘We’re looking forward to seeing larger trials to confirm whether this antioxidant is a safe and effective treatment for MS.’